♪ Bob and Brad the two most famous ♪ ♪ physical therapists on the internet ♪ - Hi folks I'm Bob Shrupp,
physical therapist. - Brad Heineck physical therapist. - Together we are the most famous physical therapists on the internet - In our opinion of course, Bob. - Today we're going to show you how to self-treat pain
on the side of your hip. Now this could be if you're diagnosed with trochanteric bursitis
or gluteal tendinopathy. We just did a video on this,
trying to help diagnose it. The problem is they both
present the same way. Luckily they're also treated the same way and that's what we're
gonna show you today. - Right. - So we got some treatment
suggestions first and then we're going to do
some treatment exercises. - Sure. - So suggestion, number one, you wanna avoid repetitive stress. So like if you're maybe biking or what would be also be repetitive? - Walking.
- Probably just running and... Yeah, yeah. - I mean, you'll know
because as you do it, it hurts while you're doing
it or after you get done it's like it flares it up.
- Yeah it flares up - And you wonder why? And then, "well what was
I just doing before that?" Maybe you walked a half a mile, or you went up and down a lot of stairs. - And in that case maybe you're
gonna need to use a cane. - Yeah. - And take some stress
off the hip for awhile. - Right. And I know all of you out there I know I can hear them saying already, a lot of them don't want
to use a cane or a walker. - Not going there. - But you know, you
only use it for a while until it calms down. - Mm-Hmm. - So listen to us. (chuckles) Number two, if you actually have one leg longer than the other, and
some of you know this already. - True. - You may have been told,
you want to correct that because when you have a shorter leg... I don't know it's in... Brad
and I ever talking about this. It could be a longer leg or a shorter leg but that where you have... but usually the more stress is on the shorter leg. - Yeah. I think even, well with
walking, like you said it could be on the longer one. - This one is one of those things that's hard to do as a layperson. It's not easy to do as a
therapist or a doctor too. How do you address it? Is it a posture thing? Is it in the pelvis? - Right is it a real thing.
- So... - Cause sometimes certain
health care providers I know will have you lay down lie down, - Yes
- Flat on your back. - And they'll... if you
have your hip shifted it looks like one leg is
longer than the other, so. - I've had people that were diagnosed with leg length difference
and I thought it was give them a insert in one shoe and it wouldn't make a difference. I mean, sometimes it would,
sometimes it wouldn't. It's not as clear cut as
it seems that it should be. - Yeah, it is the easy correction though. So on the short side, you could just take a piece of carpet and cut out
the shape of a heel and... - Go to your carpet and...
(muffled laugh) - Well, you know, if you
have some laying around. - Right yeah. I've used the rubber pads,
I've put cardboard and put her up on top.
- Oh yeah, cardboard, There you go. - You cut it out to put in there. But carpet's good though Bob. - No, I like cardboard because
you can do layers then. - Right. - And you can keep layering it up until... and then try it, if it feels better, it works, great, if not, forget it. - Just take it out, yep. - The other thing is you wanna make sure you're standing correctly, especially if you stand a lot like
on a job or whatever. You don't wanna be leaning
on one side the whole time. And a lot of people do that. - And they don't even...
they're not even aware of it. - They're not even aware of it. It's a habit. - Right. And you know, there
is a way you can actually, when you lean on one
side what you're doing is you're straightening that knee. You're actually hyper extended sometimes. You can actually take tape and tape... Put a piece of tape, run it
from the back of your thigh down to your calf and tape
it when your knee is bent. And then when you stand
and try to straighten it, it'll pull, so remind you
that, "No, don't do that." And if you have trouble breaking a habit, you could try that. You also wanna sit correctly
and I'm guilty of this one. I don't know why, but when
I eat at my kitchen counter, I have a stool and for some reason, it's just more comfortable
for me to be on one side. - Sure. - And it's not a good
thing if you're having either one of these problems to be doing. It's just... yeah. - This is a really bad habit. It's hard on the knees,
it's hard on the... tilts your hip, it puts
stress on your back. And some people have
been doing it for years. And I think as you get older,
that could catch up with you. - That all catches up to you. Muscles shorten that shouldn't be, muscles lengthen that shouldn't be, and they start causing pain. All right, you wanna sleep correctly. You really wanna avoid
sleeping on the painful side. - Right. - But if you're not sleeping
on the painful side, let's say you're sleeping
on the non-painful side. You still gotta make a correction here, because if you lie down on... And your painful hip is right here. - Yep. - And you do something like
this, or even like this. There's stress on it. - Right? - So you wanna get a
pillow in between the knees and that levels it out and
take stress off the hip all night long. And most people, you put
that pillow on and say, "Oh yeah, that does feel better." - Yeah right. - But then you don't have
a pillow for your head. - Well, you gotta have another pillow. - Get another pillow, take
it from your wife, whoever. - Yeah, you'll find out. I actually use a kind
of a different pillow because it gets warm.
- Is it one made for that? - Yeah, it's kinda made for it. Yeah. All right. Next one, u.se a cane
in the opposite hand, which we kind of alluded to when we talked about with walking. - So here's my painful hip. I'm gonna use it in my left hand. And that'll take... there's
that show that Dr. Shore, where he's got a painful right leg. - The doctor. - And he's a doctor and he
doesn't know how to use his cane. - House, Dr. House. - Dr. House, that poor guy. - Yeah. But so you want to use an opposite side bio-mechanically, physics
wise, it works better. It takes more stress off off the hip. - No doubt about it. - And you'll walk with less of a limp. - Yep. - And again, we emphasize
again if you need it, use it. All right. Now, we're gonna go to some
of the treatment exercises. This is a progression. We're gonna start with just strengthening without movement, which
is isometric strength. - Right? - So we are gonna need a belt. You have the bell Brad. Oh yeah. We've got one right here, Bob. - So, Brad's going to put a
belt on, around his thighs and he's gonna start in bed. He's actually gonna lay
down flat on his back and he's gonna work on
spreading his legs out but the belt will stop him from doing so. - So you put that belt through this. - And that strengthens... - Above the knees would probably be the best location for this belt. - Yeah. And you can do it with your legs bent or you can do it with your legs straight. How much of a warm set? - So I'm pushing out the
belt, simply just locks your knees in so you get
that isometric strengthening on your hips.
- There you go Brad. - Oh, thank you. You know, we could start here. It's gonna work a little
different fibers of the hip. - That's exactly, it will. You're gonna get both fibers if you do it with bent and straight. - I usually do my isometrics
about six, five, six seconds. Count in my head, 1001...
- And I do 10 reps. - Yep.
- Yep. - So if this hurts down
here, but it feels good here, I would go up to here and do it here. You know, when you're standing,
your hips are straight. So this would probably be
a little more functional. - Yeah you don't wanna flare up the hip. But you know, you can
control with how much stress you put on it and put on
how much it can tolerate. If it can tolerate a full pull, go ahead and you let her rip. - Yeah. Push it hard as you can. If you put your fingers
right here above your hip you'll feel those muscles
kick in, very clearly and that gives you some good feedback. - It gives you some motivation. Brad, you can stand up
and actually the next one is you're actually gonna do that standing. Now you'll probably need
to hang on to something. - Yeah. Now this was going to fall down, so just, you know, don't use the belt. I'm gonna hold onto this for balance. I gotta work my left leg. - It's supposed to be isometric. Oh, you're gonna push against something. - Yeah.
- Oh! - I'm gonna push against
a sturdy table leg or... - Leave it to Brad, right away he's gonna come up with an improvement. - Good part. Well, that was kinda hard to hold. - Yeah, I understand that. - I'm gonna push and relax. You know, you can have a chair over here. You may... if your balance is good. Yeah, you could go up against the wall and push against it that way. - Sure, right here. - Yup. - If you push through the wall, you know you're really strong. - All right. The next one is called
the reverse clam shell. Now some of you may have
heard of the clam shell. Which is actually you look like a clam, you know, you're move the leg... But now these two muscles,
two that are involved and the bursa too, it really
doesn't affect the bursa. But it's gluteal tendinopathy? There's the gluteus
medius, gluteus minimus. And they are internal rotators. One of them does both, but it
turned the hip in like this. - Yep. So the femur goes this way,
so watch his foot goes up. The knees staying together. - Yep. - And now the clam shell
does just the opposite where the feet stay together
but they're both working for... It's a nice exercise cause
they compliment each other the clamshell and the reverse. - Yeah, this actually gets
to the glute back better. Cause that's an external rotator. So you're going to start
off with putting your knees together and lifting up
your heels on just one side. And that's how you're
going to progress this. You're gonna start off with that. - Yeah. How high you can lift your foot is gonna vary from person to person. Some of you might not
how much motion there. - Right. - And some of you may have a lot. So we're gonna have you do that 10 times. It's funny Brad, you know, - You feel that don't ya? - It seems like nothing,
but you start to feel that burn when you get up to that 10. All right. The advance for there is these
muscles also abduct the hip. They bring the hip up like that. - Right. - So now you're gonna do both. You're gonna do hip abduction and you're gonna do internal rotation. - So he's got this gap in here,
which is working a muscle. I've never done these before, so I had to, - This is a coordination. - It is a little coordination. - If you have problems doing
it, you're not feeling right. - And believe me, you
feel that one faster. - Sure. - And then it gets some different fibers. You're actually gonna do it in extension. Am I out of the way? - Yep. Don't worry I'm just gonna... - So you're gonna bring the hip back and then you're gonna flip the... Turn it inside or turn
it internal rotation. - So the knee goes this way. - Yeah. I'd go back further. - If you're not doing
this or if you're elderly or you haven't done a
lot of exercise, you know those are gonna be a little challenging, - Here's the advanced one then Brad, the final one that you'll work up to is you actually, you're going to
do a plank, a sideline plank and you can start on your knees. And then you're gonna
try to do hip abduction while you're doing it. - Here Bob, can you do that
without your hand there so people can see. Yeah, so this is gap here. He's got this hip up. So he's working both hip and glutes. - This one below is really
working hard right now. And then if you get real advanced, I'm gonna go off the mat here. (chuckles)
- Get rid of shallow Bob. - Oh geez. - You know, if you're at this level, you're probably a younger person. - You're probably...
- Or a very fit senior. - Yup. There you go. So there you go. 10 times on each one of those. You can do them, probably
I'd say every other day. I wouldn't do them every day. Yeah until you to get stronger, you gotta listen to your body. If you're sore, you know, you
just did them the first time, you're sore the next
day take that day off. Wait for the next day, for sure. - Cause you're trying to build
up muscle not make it worse. - Right, you don't wanna
get things flared up. Bob are we gonna mention this PDF. - Yeah, this video by the way is part of a series of videos on hip pain. So if you're interested in
seeing those, this free series, go to bobandbrad.com, go
to the program section and look for hip pain and under hip pain, you're gonna find a whole bunch of videos. All about the hip, go to the
title that fits your need. Pick the title that you want to watch. You don't have to watch every one. And then with each video, we also have - A printout which is a
review of the whole video, with the exercises and whatnot. So you can take that
and use it for a review later on with the video
off, it's all free. You don't need your email. It's just a heck of a deal. - We're giving people. So, all right.
- Yeah. it really is. All right, thanks for watching. (feel good music)
